Assessment of autonomic status and neutrophil lymphocyte ratio in type 2
diabetics and its correlation with their disease duration

Vishnu Priya K¹,
Anitha A²,
Narmadha Lakshmi R³
Ravi S4
Getrude Banumathi P5

¹Year Post-Graduate,
²Professor, Department of Physiology,
³Department of Internal Medicine
4Department of Pathology
5Associate Professor
Department of Community Medicine,
Chengalpattu Medical College,
Chengalpattu, Tamilnadu, India

  • Background: Cardiac Autonomic Neuropathy (CAN) is a significant cause of morbidity and mortality in Type 2 Diabetes Mellitus (DM). Association between Diabetes Mellitus and cardiovascular status using Heart rate variability (HRV) has been shown in many studies. Chronic inflammation plays a central role in the development, progression and pathogenesis of Type 2 Diabetes Mellitus and particularly leucocytes play a key role in it. Neutrophil Lymphocyte Ratio (NLR) is a marker in acute coronary syndrome, Stroke and in Ulcerative colitis. With this background, HRV and NLR were assessed in Type 2 DM.
  • Aim: To correlate the Autonomic status and Neutrophil Lymphocyte ratio with Duration of Type 2 DM.
  • Materials and Methods: A cross-sectional study was done after Institutional Ethics Committee approval, with written informed consent on 135 Type 2 DM patients of age 30 to 60 years of both Gender.3 groups were taken based on their disease duration (in years) as A – 1 to 5, B – 6 to 10, C – More than 10. Complete Blood Count was done by Automated Sysmac Analyser and NLR was calculated. Autonomic status was assessed by the Compass 31 Questionnaire and HRV and data analyzed using SPSS 21.0.
  • Results: Progressive increase in mean NLR, mean LF nu, mean LF/HF ratio was seen from Group A to C. “p-value” less than 0.05 was taken as significant. Correlation between NLR and LF/HF ratio(r =0.249) showed a Positive association.
  • Conclusion: NLR can also be used as a screening tool in Type 2 DM at an earlier stage for further assessing Cardiac Autonomic Neuropathy (CAN).

Keywords: cardiac autonomic neuropathy, heart rate variability, neutrophil lymphocyte ratio, type2DM